Hi. I have just started my course of 6 zoledronic acid injections - second one in January. I have never had a bone density test since being diagnosed with breast cancer. I had one 5 years ago after breaking my wrist and my bone density was fine. Can i ask for a test to see if i really need the infusions? The consultant said i should have them because i am slim. My real concern is actually regarding the high dose Calcium & vitamin D tablets I am now prescribed for 3 years. I have never had my calcium level tested either so wonder if they are really necessary - never showed any signs of a deficiency. They contain sucrose and other additives that i would really rather not have. I feel that i have been prescribed the zolodronic acid and calcium without being checked that i need them. Should/can I write to my consultant and ask for testing? Thank you
I am about to complete my. Course of zometa infusions. The anastrozole I am on can cause bone loss, hence the infusions and calcium tablets. I have a blood test before every infusion to check my calcium levels and liver function etc. Not only do the infusions help against bone density loss they offer a small increased support of prevention of the cancer returning.
I’d speak to someone about your concerns for reassurance but they wouldn’t offer anything without good reason.
Hope things go well for you.
@bbvp I was going to say exactly the same as @JeanAnn . I’ve had 2 ZoledronicAcid infusions so far. I’ve been told that they help reduce the risk of recurrence in the bones and that the Letrazole I’m on can cause bone loss.
I’ve haven’t had a bone density scan. The calcium is checked every time I have a blood test, which has been quite frequently as I’m on Abemaciclib too. In fact my calcium levels became a little high so I now just take it twice a week, except for a tablet every day on either side of the Zoledronic Acid infusion.
Hi,
I’m with you about the calcium tablets, I hate taken them. I was only ever prescribed 1 a day but I have just finished taking two years of Abemaciclib and have my last Zometa infusion on 5th Dec. My calcium levels were 2.5 three weeks ago(high side of normal) and as I will be having calcium levels checked before the zometa infusion in Dec, I’ve decided to have a break. I have porridge every morning made with milk and I’m having a pot of organic kefir each day and if my levels are still okay I will take a calcium tablet every other day. I’ve never been given a dexa scan. After 5 years of letrozole I will try and get one on the NHS to help me decide if I will continue with Letrozole for the full 10 years. There is promising research which suggests SERDs reduce the risk of recurrence more than amitrose inhibitors in women who have oestrogen breast cancer. They are not yet approved by the FDA or NICE but I suspect they will be in the future.
Dear @bbvp, your instincts are correct. If you are going on to hormone therapy you should be offered a bone density scan before starting treatment to establish your baseline.
Like you I was offered AdCal with zero reference to my notes. When I pointed out that my last blood tests showed high calcium the oncologist looked it up and then quickly backtracked saying Oh yes, you don’t need that.
I was prescribed vit d separately by my GP as I has osteopenia but had to be taken off it recently by my endocrinologist as I had developed early hyperthyroidism (often characterised by high calcium and vit d toxicity).
Asking for a simple blood test before starting treatments is a perfectly reasonable request.
Love Tulip x
Hi
You could try asking your GP to refer you for a dexa scan if you have problems getting In touch with your consultant. The GP could also do a blood test to check your calcium levels. Your GP is still there for you all the way through treatment.
From what I’ve read in the past, the Dexa scan seems to be a bit hit and miss perhaps depending on the health board. My Onco said there was no need, he had no reason to suspect I had any bone loss before treatment started, but with the Zoledronic and calcium/vitamin supplements that would counter any issues with hormone therapy.
On the calcium, there’s a blood test before each infusion that checks liver function and calcium. If you have concerns ask for the results so you know where you are and follow up if you feel they have not spotted it. Vitamin D (so I’ve read again) many people have a low count but not aware of it.
I like the Calcichew tablets but not to chew, suck them and they’re like a sweet 
Best wishes
Hello bbvp,
Thanks for posting.
As @JeanAnn and @Pat say, some treatments for breast cancer, such as aromatase inhibitors, can increase the risk of developing osteoporosis. Bisphosphonates such as zoledronic acid may be given to protect your bones or to treat osteoporosis whilst having treatment for breast cancer. For primary breast cancer, bisphosphonates may be used to reduce the risk of breast cancer spreading to the bones and other parts of the body, and generally prescribed for women who have been through the menopause (post-menopausal women).
If your treatment team is concerned about your risk of developing osteoporosis and fractures, they may suggest a DEXA (dual energy x-ray absorptiometry) scan or DXA scan to check your bone strength before you start treatment. As you have not yet had one of these, it is something you could speak to your consultant about.
It is understandable you are concerned about your calcium levels. Although routine testing of calcium is not carried out, blood tests to check vitamin D and calcium levels are usually checked before each zoledronic acid infusion as @sal1 says. You may find this information on zoledronic acid from the Royal Osteoporosis Society helpful to refer to As @Tulip29 and @Lizaki say, you could speak to your consultant or your GP about this.
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